title: Comparison of volume-controlled and pressure-controlled ventilation in steep Trendelenburg position for robot-assisted laparoscopic radical prostatectomy.
abstract: OBJECTIVE
  To compare the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) on respiratory mechanics and hemodynamics in steep Trendelenburg position.
  
  
  METHODS
  Prospective, randomized clinical trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  34 ASA physical status 1 and 2 patients undergoing RLRP.
  
  
  METHODS
  Patients were randomly allocated to either the VCV (n = 17) or the PCV group (n = 17). After induction of anesthesia, each patient's lungs were ventilated in constant-flow VCV mode with 50% O(2) and tidal volume of 8 mL/kg; a pulmonary artery catheter was then inserted. After establishment of 30° Trendelenburg position and pneumoperitoneum, VCV mode was switched to PCV mode in the PCV group.
  
  
  METHODS
  Respiratory and hemodynamic variables were measured at baseline supine position (T1), post-Trendelenburg and pneumoperitoneum 60 minutes (T2) and 120 minutes (T3), and return to baseline after skin closure (T4).
  
  
  RESULTS
  The PCV group had lower peak airway pressure (AP(peak)) and greater dynamic compliance (C(dyn)) than the VCV group at T2 and T3 (P < 0.05). However, no other variables differed between the groups. Pulmonary arterial pressure and central venous pressure increased at T2 and T3 (P < 0.05). Cardiac output and right ventricular ejection fraction were unchanged in both groups.
  
  
  CONCLUSIONS
  PCV offered greater C(dyn) and lower AP(peak) than VCV, but no advantages over VCV in respiratory mechanics or hemodynamics.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul 120-752, Korea.
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Choi
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jiwon
authors.initials: J
authors.lastname: An
authors.forename: Koon Ho
authors.initials: KH
authors.lastname: Rha
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D018475:Head-Down Tilt; D006439:Hemodynamics; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics; D012371:Robotics / Q000379:methods*